Laurel L Edgecomb, MA, PPS, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

45659 Issued in CA

Practice address

1766 Lacassie Ave
Suite 104
Walnut Creek, CA 94596-7099

Phone

(925) 914-0444

NPI assigned

Jan 6, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1720476252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 HAMBLETONIAN LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945984604",
            "telephone_number": "925-914-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1766 LACASSIE AVE",
            "address_2": "SUITE 104",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945967099",
            "telephone_number": "925-914-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGECOMB",
        "first_name": "LAUREL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, PPS, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Eberlin, M.D.
• John Ebisui, D.P.M.
• Monica Echavarria
• Svitlana Eckmann, DO
• Shelby Lin Edgar, OTD, OTR/L
• Pia Marie Edlagan-Ortez, RN, CNS
• Babak Edraki, MD
• Tanees Iftikhar Edraki, MD
• Dejanae Edwards
• Elizabeth Dawn Edwards

• Marriage & Family Therapist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.